Medical cannabis: considerations for the anesthesiologist and pain physician

• Published in: Canadian journal of anesthesia 2016-05, Vol.63 (5), p.608-624
• Main Authors: Beaulieu, Pierre, Boulanger, Aline, Desroches, Julie, Clark, Alexander J.
• Format: Article
• Language: English
• Subjects: Analgesics; Anesthesiology; Anesthesiology - methods; Canada; Cardiology; Clinical trials; Critical Care Medicine; Drug and Narcotic Control - legislation & jurisprudence; Government Regulation; Humans; Intensive; Licenses; Licensing; Medical marijuana; Medical Marijuana - administration & dosage; Medical Marijuana - adverse effects; Medicine; Medicine & Public Health; Pain; Pain - drug therapy; Pain Medicine; Pediatrics; Pneumology/Respiratory System; Review Article/Brief Review
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/s12630-016-0598-x

Purpose New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain. Source The new Canadian regulations on the use of medical cannabis, the provincial regulations, and the various cannabis products available from the Canadian Licensed Producers were reviewed from Health Canada, provincial licensing authorities, and the licensed producers website, respectively. Recent clinical trials on cannabis and pain were reviewed from the existing literature. Principal findings Health Canada has approved a new regulation on medical marijuana/cannabis, the Marihuana for Medical Purposes Regulations: The production of medical cannabis by individuals is illegal. Health Canada, however, has licensed authorized producers across the country, limiting the production to specific licenses of certain cannabis products. There are currently 26 authorized licensed producers from seven Canadian provinces offering more than 200 strains of marijuana. We provide guidance for the safe use of medical cannabis. The recent literature indicates that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain. Conclusion The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios.